Sustaining evidence-based prevention programs: correlates in a large-scale dissemination initiative

Abstract

Over the past four decades, significant strides have been made in the science of preventing youth problem behaviors. Subsequently, policymakers and funders have begun to insist on the use of evidence-based programs (EBPs) as a requirement for funding. However, unless practitioners are able to sustain these programs beyond initial seed funding, they are unlikely to achieve their ultimate goal of broad public health impact. Despite its obvious importance, sustainability has received relatively little attention in prevention science until recently. Moreover, there have been few opportunities to study the correlates of sustainability in large-scale, multi-year initiatives involving multiple programs. The present study examined rates of sustainment of a wide range of proven-effective prevention and intervention programs; identified factors related to organizational support and readiness, program and implementer characteristics, and sustainability planning that distinguished sustained programs; and examined variability in these associations across classroom-based, community/mentoring, family-focused prevention, and family treatment program types within the context of a state-wide EBP dissemination initiative in Pennsylvania over 4 years. The majority of EBPs sustained functioning 2 years or more beyond their initial funding. In general, sustained programs reported greater community coalition functioning, communication to key stakeholders, knowledge of the program's logical model, communication with the trainer or program developer, and sustainability planning. In addition to these universal correlates, important program-specific correlates emerged as well. Implications for the technical assistance and support necessary to promote the sustainability of EBPs in nonresearch contexts are also discussed.